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Antiviral Agents

A Double-Blind Placebo-Controlled Crossover Trial of Intravenous Magnesium Sulfate for Foscarnet-Induced Ionized Hypocalcemia and Hypomagnesemia in Patients with AIDS and Cytomegalovirus Infection

Mark M. Huycke, M. Tarek Naguib, Mathias M. Stroemmel, Kenneth Blick, Katherine Monti, Sarah Martin-Munley, Chris Kaufman
Mark M. Huycke
Departments of Medicine and
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M. Tarek Naguib
Departments of Medicine and
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Mathias M. Stroemmel
Departments of Medicine and
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Kenneth Blick
Pathology, University of Oklahoma Health Sciences Center and Department of Veterans Affairs Medical Center, Oklahoma City, Oklahoma 73190, and
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Katherine Monti
Astra USA, Inc., Westborough, Massachusetts 01581-4500
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Sarah Martin-Munley
Astra USA, Inc., Westborough, Massachusetts 01581-4500
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Chris Kaufman
Departments of Medicine and
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DOI: 10.1128/AAC.44.8.2143-2148.2000
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ABSTRACT

Foscarnet (trisodium phosphonoformate hexahydrate) is an antiviral agent used to treat cytomegalovirus disease in immunocompromised patients. One common side effect is acute ionized hypocalcemia and hypomagnesemia following intravenous administration. Foscarnet-induced ionized hypomagnesemia might contribute to ionized hypocalcemia by impairing excretion of preformed parathyroid hormone (PTH) or by producing target organ resistance. Prevention of ionized hypomagnesemia following foscarnet administration could blunt the development of ionized hypocalcemia. To determine whether intravenous magnesium ameliorates the decline in ionized calcium and/or magnesium following foscarnet infusions, MgSO4 at doses of 1, 2, and 3 g was administered in a double-blind, placebo-controlled, randomized, crossover trial to 12 patients with AIDS and cytomegalovirus disease. Overall, increasing doses of MgSO4 reduced or eliminated foscarnet-induced acute ionized hypomagnesemia. Supplementation, however, had no discernible effect on foscarnet-induced ionized hypocalcemia despite significant increases in serum PTH levels. No dose-related, clinically significant adverse events were found, suggesting that intravenous supplementation with up to 3 g of MgSO4 was safe in this chronically ill population. Since parenteral MgSO4 did not alter foscarnet-induced ionized hypocalcemia or symptoms associated with foscarnet, routine intravenous supplementation for patients with normal serum magnesium levels is not recommended during treatment with foscarnet.

  • Copyright © 2000 American Society for Microbiology
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A Double-Blind Placebo-Controlled Crossover Trial of Intravenous Magnesium Sulfate for Foscarnet-Induced Ionized Hypocalcemia and Hypomagnesemia in Patients with AIDS and Cytomegalovirus Infection
Mark M. Huycke, M. Tarek Naguib, Mathias M. Stroemmel, Kenneth Blick, Katherine Monti, Sarah Martin-Munley, Chris Kaufman
Antimicrobial Agents and Chemotherapy Aug 2000, 44 (8) 2143-2148; DOI: 10.1128/AAC.44.8.2143-2148.2000

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A Double-Blind Placebo-Controlled Crossover Trial of Intravenous Magnesium Sulfate for Foscarnet-Induced Ionized Hypocalcemia and Hypomagnesemia in Patients with AIDS and Cytomegalovirus Infection
Mark M. Huycke, M. Tarek Naguib, Mathias M. Stroemmel, Kenneth Blick, Katherine Monti, Sarah Martin-Munley, Chris Kaufman
Antimicrobial Agents and Chemotherapy Aug 2000, 44 (8) 2143-2148; DOI: 10.1128/AAC.44.8.2143-2148.2000
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KEYWORDS

AIDS-Related Opportunistic Infections
Acquired Immunodeficiency Syndrome
Cytomegalovirus Infections
Hypocalcemia
Magnesium
Magnesium Sulfate

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